Clinical Differentiation of Respiratory Nursing Diagnoses among Children with Acute Respiratory Infection

J Pediatr Nurs. 2016 Jan-Feb;31(1):85-91. doi: 10.1016/j.pedn.2015.08.002. Epub 2015 Sep 4.


The aim of this study was to identify the defining characteristics that allow clinical differentiation of the nursing diagnoses, ineffective breathing pattern (IBP), ineffective airway clearance (IAC), and impaired gas exchange (IGE). A secondary analysis with a cohort design was developed from 1128 records obtained during the hospital stay of 136 children with acute respiratory infection. Groups of defining characteristics with greater differentiation capacity were identified by multiple correspondence analyses. The results showed that the defining characteristics that better differentiate the studied diagnoses are agitation, irritability and diaphoresis for IGE; dyspnea, use of accessory muscles to breathe, orthopnea, and abnormal breathing pattern for IBP and excessive sputum, absence of cough, difficulty verbalizing, nasal flaring, and adventitious breath sounds for IAC. Twelve defining characteristics that can assist clinicians to differentiate the three main respiratory nursing diagnoses among children with acute respiratory infection were identified in this study.

Keywords: Nursing assessment; Nursing diagnosis; Pediatrics; Respiratory signs and symptoms.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Airway Obstruction / diagnosis*
  • Airway Obstruction / nursing
  • Child
  • Child, Preschool
  • Clinical Competence*
  • Cohort Studies
  • Diagnosis, Differential
  • Female
  • Humans
  • Male
  • Nursing Assessment
  • Nursing Diagnosis / standards*
  • Pediatric Nursing / standards
  • Pediatric Nursing / trends
  • Pulmonary Gas Exchange*
  • Respiratory Tract Infections / diagnosis*
  • Respiratory Tract Infections / nursing
  • Risk Assessment
  • Severity of Illness Index
  • Work of Breathing